Is concierge medicine ethical, or elitist?

Massachusetts General Hospital (MGH), perhaps the most prestigious hospital in the United States, has just announced that it is joining the concierge medical universe. Concierge medicine offers patients Rolls Royce care for an extra fee. This model has gained popularity across the country and is attracting both patients and physicians. Patients receive white glove treatment on demand and physicians have more time with each patient as they no longer are pressured to increase patient volume to pay bills. I'm sure that some of these physicians have increased their incomes, but others may be paid the same, but enjoy seeing 6 patients per day instead of 20.

I was struck by $6,000 annual feel that MGH was charging concierge patients, the highest I had ever seen before. The typical fee I had seen was in the $1,500 per year range. Six grand per year will get Bay Staters personalized care whenever they want. They will never wait for an appointment. I imagine that the waiting rooms will be Zen gardens, with music, art and aromas that create an aura of wellness.

Keep in mind that the concierge medicine fees are in addition to medical insurance payments.

A criticism of concierge medicine is that it is an elitist, 2-tiered system of medicine for Americans. This is ridiculous. We already have a multiple-tiered medical system in place. Does anyone doubt that wealthy individuals receive a different level of medical care and quality? Concierge medicine is simply another avenue for them to do so. Incidentally, this option is not just for the wealthy. I know working people here in Cleveland who have paid a $1,500 yearly fee because they are frustrated with the medical status quo and are willing to pay more for a higher quality product. Another working family may decide instead to pay $1,500 for a family vacation. We all have different priorities.

While I believe that every American is entitled to receive quality medical care, I don't believe that someone should be prevented from paying more for a higher quality of service. The same argument applies to college education, automobiles, vacations, homes, and legal advice. Preventing folks from paying more to get more harms them, but helps no one else.

I have also eschewed concierge blogging. No elitism on this site. I give it all away for free.

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.

Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness.
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